• The Korean Journal of Pain
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• v.28 no.3
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• pp.169-176
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• 2015

This review has focused on important but less visible aspects of fibromyalgia (FM) with respect to the high impact of this disorder on patients and societies. FM is a common but challengeable illness. It is characterized by chronic widespread pain, which can be accompanied by other symptoms including fatigue, sleep disturbances, cognitive dysfunction, anxiety and depressive episodes. While our understanding of this debilitating disorder is limited, diagnosis and treatment of this condition is very difficult, even in the hands of experts. Due to the nature of disease, where patients experience invalidation by medical services, their families and societies regarding the recognition and management of disease, direct, indirect and immeasurable costs are considerable. These clinical and economic costs are comparable with other common diseases, such as diabetes, hypertension and osteoarthritis, but the latter usually receives much more attention from healthcare and non-healthcare resources. Present alarming data shows the grave and "iceberg-like" burden of FM despite the benign appearance of this disorder and highlights the urgent need both for greater awareness of the disease among medical services and societies, as well as for more research focused on easily used diagnostic methods and target specific treatment.

• Journal of KIBIM
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• v.9 no.2
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• pp.1-10
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• 2019

In this research, schedule optimization is defined as balancing the number of workers while keeping the demand and needs of the project resources, creating the perfect schedule for each activity. Therefore, when one optimizes a schedule, multiple potentials of schedule changes are assessed to get an instant view of changes that avoid any over and under staffing while maximizing productivity levels for the available labor cost. Optimizing the number of workers in the scheduling process is not a simple task since it usually involves many different factors to be considered such as the development of quantity take-offs, cost estimating, scheduling, direct/indirect costs, and borrowing costs in cash flow while each factor affecting the others simultaneously. That is why the optimization process usually requires complex computational simulations/modeling. This research attempts to find an optimal selection of daily maximum workers in a project while considering the impacts of other factors at the same time through OPEN BIM based multiple computer simulations in resource leveling. This paper integrates several different processes such as quantity take-offs, cost estimating, and scheduling processes through computer aided simulations and prediction in generating/comparing different outcomes of each process. To achieve interoperability among different simulation processes, this research utilized data exchanges supported by building SMART-IFC effort in automating the data extraction and retrieval. Numerous computer simulations were run, which included necessary aspects of construction scheduling, to produce sufficient alternatives for a given project.

• International conference on construction engineering and project management
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• 2009.05a
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• pp.493-498
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• 2009

Recently, the number of complex construction projects, such as high-density development and long-span mega structure construction, has been increasing globally. Therefore, the construction duration has become an even more important factor for success. Nevertheless, in domestic residential construction projects, it usually takes more time than twice as much as North American cases. The long construction duration causes a number of problems, for example growth of financial costs, fall in productivity, and weakness of competitiveness. If the framework construction duration can be shortened to 3 ~ 4 days, then it is also expected to complete the finish work of building in shorter duration, be led to reduce the entire construction duration, and eventually to save a great deal of indirect costs. For shortening the construction duration, previous researches pointed out that the development of simplified plan design should precedes. But, in reality, lack of experience of new design and innovative techniques tends to be the obstacle to wide adoption of the simplified plan design in construction fields. In this paper, a simplified structural plan design is proposed, and the construction cost is quantitatively compared between when traditional construction technique is applied to the traditional plan and when the duration-shortening key technique is applied to the developed plan.

• Journal of Korea Port Economic Association
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• v.33 no.2
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• pp.97-109
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• 2017

The Terminal Operating Company (TOC) decides to replace the harbor cranes in order to increase revenue and profit through the improvement of unloading efficiency. To achieve this goal, substantial costs and efforts are necessary. However, the conative participation of harbor stakeholders is needed, because they will certainly be passionate enough when expected effects are obvious. The purpose of this study is to analyze the effect on stakeholders on direct and indirect cost saving when the cargo handling equipment is replaced. According to the analysis, a total cost saving of 6,561.8 million won will arise including a vessel chartering fee of 3,649.6 million won, a port facility fee of 1,528.8 million won, and fuel costs of 1,383.4 million won as direct effects. As indirect cost effects, a total cost saving of 3,107.0 million won will emerge including an environmental pollution cost of 2,134.8 million won and a freight inventory cost of 972.2 million won. Consequently, the replacement of harbor cranes in the TOC has positive effects on shipping companies, shippers, and the government in terms of costs and other aspects. The results of this study can be utilized as a basis to draw a conative cooperation of stakeholders on TOC's promotion of the harbor cranes replacement.

• Proceedings of the Korean Society of Near Infrared Spectroscopy Conference
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• 2001.06a
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• pp.3103-3103
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• 2001

NIR has been extensively used to predict directly measurable properties of materials that are important to the appropriate industries. Commonly, NIR is used to perform fast, routine tests to improve control response as against the response time for the (normally chemical) base test. This paper discusses the use of NIR to measure indirect properties of materials. In these cases, the pure chemical or physical tests are either unable measure the appropriate parameters (eg GMO modification) or there are mitigating effects that are not properly addressed by the base tests. In particular, we looked at the digestible portion of amino acids within meat and bone meal. This is the desired response measurement by end-users of the product (intensive livestock producers) but is currently unable to be offered as a measurement by producers. The base test method is by controlled feeding trials. These are somewhat cumbersome, taking 2-3 months, involving several sets of animals, and considerable expense. A shortened test (feed trial based) would be of little use, as the precision blows out over short period feeding trials. For example, a rat ileal digestibility test requires around 2 months, and costs some $USD1000. This is clearly impractical test for a producer involved in continuous production, with a 1-2 day turn around. While the amino acid abundance is accessible chemically, the uptake of amino acids into usable material by mammalian species is not simply related to the measured abundance within the material. There are many co-related material properties that might help or hinder uptake, some chemical based (eg protein damage), some indirect (eg palatability), some physiological (intestinal tract response vs speed of throughput). We discuss the approaches taken to provide a suitable reference data set, and present the derived prediction and validation relationships.

• Journal of Preventive Medicine and Public Health
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• v.45 no.5
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• pp.291-300
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• 2012

Objectives: We aimed to estimate the annual socioeconomic burden of coronary heart disease (CHD) in Korea in 2005, using the National Health Insurance (NHI) claims data. Methods: A prevalence-based, top-down, cost-of-treatment method was used to assess the direct and indirect costs of CHD (International Classification of Diseases, 10th revision codes of I20-I25), angina pectoris (I20), and myocardial infarction (MI, I21-I23) from a societal perspective. Results: Estimated national spending on CHD in 2005 was $2.52 billion. The majority of the spending was attributable to medical costs (53.3%), followed by productivity loss due to morbidity and premature death (33.6%), transportation (8.1%), and informal caregiver costs (4.9%). While medical cost was the predominant cost attribute in treating angina (74.3% of the total cost), premature death was the largest cost attribute for patients with MI (66.9%). Annual per-capita cost of treating MI, excluding premature death cost, was $3183, which is about 2 times higher than the cost for angina ($1556). Conclusions: The total insurance-covered medical cost ($1.13 billion) of CHD accounted for approximately 6.02% of the total annual NHI expenditure. These findings suggest that the current burden of CHD on society is tremendous and that more effective prevention strategies are required in Korea.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.18
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• pp.8265-8270
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• 2016

Purpose: A cost-utility analysis was performed to assess the cost-utility of neoadjuvant chemotherapy regimens containing doxorubicin and cyclophosphamide (AC) versus paclitaxel and gemcitabine (PG) for locally advanced breast cancer patients in Iran. Materials and Methods: This cross-sectional study in Namazi hospital in Shiraz, in the south of Iran covered 64 breast cancer patients. According to the random numbers, the patients were divided into two groups, 32 receiving AC and 32 PG. Costs were identified and measured from a community perspective. These items included medical and non-medical direct and indirect costs. In this study, a data collection form was used. To assess the utility of the two regimens, the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core30 (EORTC QLQ-C30) was applied. Using a decision tree, we calculated the expected costs and quality adjusted life years (QALYs) for both methods; also, the incremental cost-effectiveness ratio was assessed. Results: The results of the decision tree showed that in the AC arm, the expected cost was 39,170 US$ and the expected QALY was 3.39 and in the PG arm, the expected cost was 43,336 dollars and the expected QALY was 2.64. Sensitivity analysis showed the cost effectiveness of the AC and ICER=-5535 US$. Conclusions: Overall, the results showed that AC to be superior to PG in treatment of patients with breast cancer, being less costly and more effective.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.5
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• pp.1761-1766
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• 2012

Background: The appropriate interval between negative colonoscopy screenings is uncertain, but the numbers of advanced neoplasms 10 years after a negative result are generally low. We aimed to evaluate the cost-effectiveness of colorectal neoplasm screening and management based on repeat screening colonoscopy every 10 years or single colonoscopy, compared with no screening in the general population. Methods and materials: A state-transition Markov model simulated 100,000 individuals aged 50-80 years accepting repeat screening colonoscopy every 10 years or single colonoscopy, offered to every subject. Colorectal adenomas found during colonoscopy were removed by polypectomy, and the subjects were followed with surveillance every three years. For subjects with a normal result, colonoscopy was resumed within ten years in the repeat screening strategy. In single screening strategy, screening process was terminated. Direct costs such as screening tests, cancer treatment and costs of complications were included. Indirect costs were excluded from the model. The incremental cost-effectiveness ratio was used to evaluate the cost-effectiveness of the different screening strategies. Results: Assuming a first-time compliance rate of 90%, repeat screening colonoscopy and single colonoscopy can reduce the incidence of colorectal cancer by 65.8% and 67.2% respectively. The incremental cost-effectiveness ratio for single colonoscopy (49 Renminbi Yuan [RMB]) was much lower than that for repeat screening colonoscopy (474 RMB). Single colonoscopy was a more cost-effective strategy, which was not sensitive to the compliance rate of colonoscopy and the cost of advanced colorectal cancer. Conclusion: Single colonoscopy is suggested to be the more cost-effective strategy for screening and management of colorectal neoplasms and may be recommended in China clinical practice.

• Journal of Nutrition and Health
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• v.36 no.10
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• pp.1083-1093
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• 2003

Efficient financial management is a critical factor in achieving school foodservice goals. The objective of this study was to suggest efficient financial management practices in secondary school foodservices. In pursuit of this objective, we first identified performance indexes for measuring the success of financial management. Second, we suggested financial management standards, financial data classification methods and a report system. Last, we analyzed operating ratios with the financial data of self-operated and contract-managed school food services. The data were collected through an open-ended questionnaire from 10 middle/high school foodservices in Seoul and Kyeonggi Provincial during on-sites visits and interviews with dieticians and managers. Student participation, sales goals, re-contract frequency and number and cost of disaster loss were identified as the performance indexes for financial management. Income statements were compiled by identifying and classifying financial data. Total revenues consisted of subsidies, meal sales, other revenue and interest. Expenditures consisted of purchased food, salaries and wages, utility costs, office supplies, kitchen supplies, purchased services, company overhead indirect costs, facility investment and maintenance, facility usage expenses, employee benefits and miscellaneous. Mean price of a meal was 2,326 won at self-operated foodservices when the subsidies were included as revenues and 2,360 won at contract-managed foodservices. When including the subsidies as revenues, the operating ratios of self-operated foodservice showed that the food cost percentage was 66.9％, labor cost 23.2％, operation cost 9.9％ and profit 0％. The correspond figures at contract-managed foodservices were 57.6％, 21.5％, 15.3％, and 5.5％, respectively. Food costs in self-operated foodservices was significantly higher than that for contract-managed foodservices, however, facility investment and maintenance and facility usage expenses at self-operated foodservices was significantly lower than those for contract-managed foodservices. Based on this study, the methodology and classification system of financial data was found to be applicable to assess the financial structure of school foodservices.

• Journal of Korean Neurosurgical Society
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• v.62 no.1
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• pp.83-89
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• 2019

Objective : This study is a retrospective cost-benefit analysis of cervical anterior interbody fusion and cervical artificial disc replacement, which are the main surgical methods to treat degenerative cervical disc disease. Methods : We analyzed 156 patients who underwent anterior cervical disc fusion and cervical artificial disc replacement from January 1, 2008 to December 31, 2009, diagnosed with degenerative cervical disc disorder. In this study, the costs and benefits were analyzed by using quality adjusted life year (QALY) as the outcome index for patients undergoing surgery, and a Markov model was used for the analysis. Only direct medical costs were included in the analysis; indirect medical costs were excluded. Data were analyzed with TreeAge Pro $2015^{TM}$ (TreeAge Software, Inc, Williamstown, MA, USA). Results : Patients who underwent cervical anterior fusion had a total cost of KRW 2501807/USD 2357 over 5 years and obtained a utility of 3.72 QALY. Patients who underwent cervical artificial disc replacement received 4.18 QALY for a total of KRW 3685949/USD 3473 over 5 years. The cumulative cost-effectiveness ratio of cervical spine replacement surgery was KRW 2549511/QALY (USD 2402/QALY), which was lower than the general Korean payment standard. Conclusion : Both cervical anterior fusion and cervical artificial disc replacement are cost-effective treatments for patients with degenerative cervical disc disease. Cervical artificial disc replacement may be an effective alternative to obtain more benefits.